Healthcare Provider Details

I. General information

NPI: 1275635682
Provider Name (Legal Business Name): SCOTT GRAY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 01/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 HOSPITAL AVE
DANBURY CT
06810
US

IV. Provider business mailing address

33 HOSPITAL AVE
DANBURY CT
06810
US

V. Phone/Fax

Practice location:
  • Phone: 203-792-5558
  • Fax: 203-731-3213
Mailing address:
  • Phone: 203-792-5558
  • Fax: 203-731-3213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number027630
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: